The document contains a survey with 19 questions for a former vocational rehabilitation (VR) client regarding their experience with the VR application process, services received, relationship with their counselor, and any advice they would offer to future VR applicants. The questions cover topics such as the individual's disability history, VR application and services, experiences with counselors, support received for goals and equipment like wheelchairs, vehicles, home modifications, and job accommodations. The completed survey is to be returned by November 18th.